topic Re: Insurance deductibles/choosing a plan.... in Community Chat

Insurance deductibles/choosing a plan....

SahmIam — Sat, 12 Nov 2016 14:25:17 GMT

So we were presented with our insurance option (only 1) BCBS (what we've had for the past 9 years) and only one thing changed:

$5000 deductible for IN network

$10,000 for OUT of network.

Last year, it was $12,000 and everything went towards it. As per the BCBS rep and HR, this is the way most plans are and are moving towards. The BCBS rep hinted that a separate deductible for Rx's may be coming down the road.

Luckily all but 1 doc is in network but what we use the most is the Rx plan. We hit the full deductible by mid January (we go OVER it, to be honest).

Beyond, that, coverage and costs all stayed the same. Very lucky, I have to say.

Re: Insurance deductibles/choosing a plan....

INDIANA BONES — Sat, 12 Nov 2016 14:29:50 GMT

Wow, it will not take many unfortunate incidnets in the hosptial to delete a person's savings and 401 K with these deductibles. Even those that are young and healthy could have many issues come up that they need insurance. Wish they would do something with insurance for all Americans to make it affordable.

Re: Insurance deductibles/choosing a plan....

bri20 — Sat, 12 Nov 2016 14:34:56 GMT

I think those deductibles are outrageous.

s Re: Insurance deductibles/choosing a plan....

PinkyPetunia — Sat, 12 Nov 2016 15:59:33 GMT

Yes they are high deductibles but we don't know the whole picture. Is the deductible for the entire family? Does your employer offer this plan, do you contribute anything towards it or does the employer fully fund it? Is the plan a HMO, PPO?

There are so many variables. We have a high decductible too but as long as we stay in network it's not a problem.

Re: s Re: Insurance deductibles/choosing a plan....

Abrowneyegirl — Sat, 12 Nov 2016 17:01:11 GMT

It appears that the higher and higher deductables are here to stay.

If the orginal poster is referring to the deductable for her and her husband than it is not considered high by today's standard.

We are on what is considered a platiumin plan (we both work for large companies) and our deductables are going up every year as well as the co-pay. So even when you meet the deductable you are still stuck because you have to pay a % of the private insurance rate. Which of course is 8-10 times the price of what they charge those with no insurance.

There is only ways to get a free ride in this country be incarcerated or be on the dole.

The rest of us have to supplement them.

Sorry. I know I hate it too.

Re: s Re: Insurance deductibles/choosing a plan....

meem120 — Sat, 12 Nov 2016 17:12:37 GMT

Those deductibles are crazy. Its like having no insurance at all. Is this a catastropic policy only? I think you need to look into other plans. You hit your deductible by mid january?

Re: s Re: Insurance deductibles/choosing a plan....

Abrowneyegirl — Sat, 12 Nov 2016 17:36:50 GMT

@meem120 wrote:
Those deductibles are crazy. Its like having no insurance at all. Is this a catastropic policy only? I think you need to look into other plans. You hit your deductible by mid january?

I recently heard that a castastropic policy starts in the $25,000+ deductable range.

Which sounds like a lot of money until you are in the hosptial then it means 1 day.

Re: s Re: Insurance deductibles/choosing a plan....

SilleeMee — Sat, 12 Nov 2016 17:45:45 GMT

My insurance is just for myself and the deductible is 7,000. Seems like a lot but really it doesn't take much to get this high at today's high-cost medical care.

Re: Insurance deductibles/choosing a plan....

Annabellethecat66 — Sat, 12 Nov 2016 17:52:26 GMT

I am totally stupid when it comes to this. I have an insurance agent. All I do is send him the medicine I take and he puts it in the computer and figures out what would work best for my secondary insurance. I have to have Medicare as I owned my own business. Even though I DID NOT want Medicare, I had no choice....am I angry...well, yes, but it is what it is.

Most insurance agents represent many different insurance companies. I don't know about others, but I don't give him a penny. Last year he had me change to a company he doesn't represent but he said based on the fact that I can't take many generic medicines I should take a particular medicine. I'm about to change again. He's been texting me to give him my medicines. I am a genuine procrastinator...pleased to me you...Ha!

Re: Insurance deductibles/choosing a plan....

terrier3 — Sat, 12 Nov 2016 18:11:24 GMT

I am currently working for a large media company, after 2 years as a freelancer.

Our company is committed to getting and retaining the best employees they can.

Their approach to health insurance shows that they mean business!

We have 3 tiers to choose from - all BCBS PPO plans, managed by a third party company. As an individual, my monthly share of premiums is $100. With that I get a NO deductible, NO out of pocket plan with low co-pays. That was the most expensive plan. For $70 a month, the plan had a $350 annual deductible.

Starting in January, they have hired a company to manage all our health concerns. They will import brand name Tier 2 and 3 drugs from Canada, England and other safe countries for door to door delivery with NO co-pays at all. (It saves them that much money!) You can continue to use local pharmacies if you prefer and for generics with $10 copays.

Everyone who wants to gets a Fitbit and there are cash rewards of up to $250/yr. for achieving certain activity goals.

These high deductible, high out of pocket plans are choices by your employer - not by any other outside force.

I am thrilled to be working where I am now - they care for their employees. Let's cross fingers that importation of drugs will still be legal in the future!

Re: Insurance deductibles/choosing a plan....

terrier3 — Sat, 12 Nov 2016 18:15:18 GMT

@Annabellethecat66 wrote:
I am totally stupid when it comes to this. I have an insurance agent. All I do is send him the medicine I take and he puts it in the computer and figures out what would work best for my secondary insurance. I have to have Medicare as I owned my own business. Even though I DID NOT want Medicare, I had no choice....am I angry...well, yes, but it is what it is.

Most insurance agents represent many different insurance companies. I don't know about others, but I don't give him a penny. Last year he had me change to a company he doesn't represent but he said based on the fact that I can't take many generic medicines I should take a particular medicine. I'm about to change again. He's been texting me to give him my medicines. I am a genuine procrastinator...pleased to me you...Ha!

FYI - Insurance brokers are paid commissions by the insurance companies. That is how they make their money.

Why do you not want Medicare? You paid into it all your work life and can always go to a managed Medicare plan through an insurance company. Medicare was created because private insurance companies don't want to insure high risk people (seniors) because they cost too much. Medicare keeps premiums way lower than they would be otherwise for seniors.

Re: Insurance deductibles/choosing a plan....

truffle — Sat, 12 Nov 2016 18:36:12 GMT

My SO recently got a mailer from Aetna called Aetna Medicare. What is this for? He's not 65 yet, not even close. When the time comes @terrier3 are we to assume this is for managed medicare (what is meant by that vs regular medicare) or is it for a secondary ins? Thank you.

I just googled them and will read their info on their website.

Re: Insurance deductibles/choosing a plan....

SilleeMee — Sat, 12 Nov 2016 18:35:23 GMT

@terrier3,

What happens to Medicare premiums if a person doesn't qualify to receive Medicare benefits? I was a state government employee who did not pay enough Medicare tax to qualify for it when I turn 65. The payroll office where I worked did not deduct Medicare tax until late into my career. I think I'm in trouble when I turn 65. I have no spouse, alive or dead.

Re: Insurance deductibles/choosing a plan....

Isobel Archer — Sat, 12 Nov 2016 18:40:37 GMT

@terrier3 wrote:
I am currently working for a large media company, after 2 years as a freelancer.
Our company is committed to getting and retaining the best employees they can.

Their approach to health insurance shows that they mean business!

We have 3 tiers to choose from - all BCBS PPO plans, managed by a third party company. As an individual, my monthly share of premiums is $100. With that I get a NO deductible, NO out of pocket plan with low co-pays. That was the most expensive plan. For $70 a month, the plan had a $350 annual deductible.

Starting in January, they have hired a company to manage all our health concerns. They will import brand name Tier 2 and 3 drugs from Canada, England and other safe countries for door to door delivery with NO co-pays at all. (It saves them that much money!) You can continue to use local pharmacies if you prefer and for generics with $10 copays.

Everyone who wants to gets a Fitbit and there are cash rewards of up to $250/yr. for achieving certain activity goals.

These high deductible, high out of pocket plans are choices by your employer - not by any other outside force.

I am thrilled to be working where I am now - they care for their employees. Let's cross fingers that importation of drugs will still be legal in the future!

Well that's great for you - and for people who work for companies that provide good insurance.

Are you saying you would get the same coverage on the Exchanges for that price - or even double that price? Because that's where the ACA put an awful lot of people. Employers - with all the new requirements, were essentially incentivized to reduce hours so that they didn't have to cover people.

Re: Insurance deductibles/choosing a plan....

151949 — Sat, 12 Nov 2016 18:52:27 GMT

@terrier3 wrote:
I am currently working for a large media company, after 2 years as a freelancer.
Our company is committed to getting and retaining the best employees they can.

Their approach to health insurance shows that they mean business!

We have 3 tiers to choose from - all BCBS PPO plans, managed by a third party company. As an individual, my monthly share of premiums is $100. With that I get a NO deductible, NO out of pocket plan with low co-pays. That was the most expensive plan. For $70 a month, the plan had a $350 annual deductible.

Starting in January, they have hired a company to manage all our health concerns. They will import brand name Tier 2 and 3 drugs from Canada, England and other safe countries for door to door delivery with NO co-pays at all. (It saves them that much money!) You can continue to use local pharmacies if you prefer and for generics with $10 copays.

Everyone who wants to gets a Fitbit and there are cash rewards of up to $250/yr. for achieving certain activity goals.

These high deductible, high out of pocket plans are choices by your employer - not by any other outside force.

I am thrilled to be working where I am now - they care for their employees. Let's cross fingers that importation of drugs will still be legal in the future!

I believe there are a lot of people who do not understand what I bolded here. They here politicans etc go on & on and they believe that the government is to blame for these terrible insurances when , in fact, it is their employer.

Re: Insurance deductibles/choosing a plan....

Isobel Archer — Sat, 12 Nov 2016 19:50:08 GMT

@151949 wrote:
@terrier3 wrote:
I am currently working for a large media company, after 2 years as a freelancer.
Our company is committed to getting and retaining the best employees they can.

Their approach to health insurance shows that they mean business!

We have 3 tiers to choose from - all BCBS PPO plans, managed by a third party company. As an individual, my monthly share of premiums is $100. With that I get a NO deductible, NO out of pocket plan with low co-pays. That was the most expensive plan. For $70 a month, the plan had a $350 annual deductible.

Starting in January, they have hired a company to manage all our health concerns. They will import brand name Tier 2 and 3 drugs from Canada, England and other safe countries for door to door delivery with NO co-pays at all. (It saves them that much money!) You can continue to use local pharmacies if you prefer and for generics with $10 copays.

Everyone who wants to gets a Fitbit and there are cash rewards of up to $250/yr. for achieving certain activity goals.

These high deductible, high out of pocket plans are choices by your employer - not by any other outside force.

I am thrilled to be working where I am now - they care for their employees. Let's cross fingers that importation of drugs will still be legal in the future!

I believe there are a lot of people who do not understand what I bolded here. They here politicans etc go on & on and they believe that the government is to blame for these terrible insurances when , in fact, it is their employer.

Not exactly. The ACA requires minimum levels of coverage - for everyone - whether or not they need/want it. For example, a young male cannot simply buy a catastrophic policy - no he has to have one that provides birth control, covers mammograms, colonoscopies, etc. etc. That coverage is not inexpensive - when applied to all employees. Thus the large deductibles to try to make it work.

In addition, the Exchanges also have high deductibles - particularly in the lower tier plans- where those eligible for subsidies are having to choose because it is all they can afford.

So to claim that the law has nothing to do with this is just not true.

And to imply that people should just find better employers is elitism at its worst.

Re: Insurance deductibles/choosing a plan....

Isobel Archer — Sat, 12 Nov 2016 19:56:09 GMT

This whole argument over insurance reminds me of the argument over public schools.

As to insurance, those of us who have it/can afford it - are so proud of ourselves because now"everyone has access" - despite the fact that many cannot afford it and many who buy with subsidies and end up with astronomical deductibles esssentially have no insurance in fact.

It's the same with the public schools. We think that if the government will just tax more and spend more it's all good. Then we have the DC public schools where graduation rates are abysmal - yet according to the Washington Post, we spend more per child than it costs to educate a child at Sidwell Friends.

If government is the answer - why isn't it working for everyone?

Re: Insurance deductibles/choosing a plan....

151949 — Sat, 12 Nov 2016 19:58:15 GMT

YES yes yes - I am aware that no doubt Satan himself is alive and well in the ACA.(note sarcasm) However - you responded to a statement about employer provided insurance with your rant and the ACA is NOT employer provided insurance.

Re: Insurance deductibles/choosing a plan....

151949 — Sat, 12 Nov 2016 20:35:52 GMT

@SilleeMee The same as your SS payments - you lose them if you don't have the required 40 quarters paid in. My first husband was a British citizen and worked for a British company most of his life even though he lived in the USA.He did not pay enough quarters into SS for me to get the death benefit but I was still paid a monthly amount for my stepchildren - though it was only $400 - which I assume is a minimum amount. I did get a widows pension from British Leyland though until I remarried.

Re: Insurance deductibles/choosing a plan....

Isobel Archer — Sat, 12 Nov 2016 21:01:02 GMT

@151949 wrote:
YES yes yes - I am aware that no doubt Satan himself is alive and well in the ACA.(note sarcasm) However - you responded to a statement about employer provided insurance with your rant and the ACA is NOT employer provided insurance.

No actually I was responding about how the ACA has levied requrements on employer provided insurance - and thus affected the cost of it.